Jul. 2, 2013

Written by

Lauran Neergaard

Associated Press

New Jersey Gov. Chris Christie attends a groundbreaking ceremony in May in Newark, N.J. Reports say Christie secretly underwent a weight-loss surgery in February, when a band was placed around his stomach to restrict the amount of food he can eat. / AP photo

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Weight-loss surgery such as the type that New Jersey Gov. Chris Christie underwent may not just improve people’s waistlines, but their health.

The governor is “doing the right thing,” said Dr. Jaime Ponce, president of the American Society for Metabolic and Bariatric Surgery. “He’s at the age he really needs to address his problem, to live longer, in a better way, with a better quality of life.”

Some questions and answers about the different types:

Question: What is the most common form of weight-loss surgery?

Answer: In the U.S., it’s gastric bypass, sometimes called stomach stapling. It generally results in the most weight loss. Doctors wall off a small pouch in the stomach, so that it can hold only a small amount of food. Then they reroute that food past part of the intestine so the body also absorbs fewer calories.

Q: How is stomach banding different?

A: It’s a less invasive operation, and unlike gastric bypass, it’s reversible — the band can be removed if necessary. Best known by the brand name Lap-Band, an adjustable band is placed around the stomach to restrict how much food someone can eat at one time. As initial weight is lost, the band can be tightened. Typically, patients don’t lose as much as with gastric bypass.

Q: Are those the only options?

A: The third major approach is called a gastric sleeve, which removes a large chunk of the stomach and thus cuts production of one of the body’s hunger-stimulating hormones. Other, less-used options include a complex operation called a duodenal switch that also involves rerouting food.

Q: How well do these operations work?

A: Over a year or two, weight-loss surgery can lead to loss of 50 percent to even 80 percent of the person’s excess weight — if they stick with a healthy diet and exercise. More important, research shows weight-loss surgeries can reverse Type 2 diabetes in patients who lose enough weight and keep it off. Gastric bypass causes the fastest weight loss and stomach banding a more gradual loss.

But patients don’t always benefit enough to justify surgery. The Agency for Healthcare Research and Quality cited reports that within five years, up to a third of stomach banding patients aren’t maintaining their weight loss.

A: Most are done laparoscopically — through small incisions — and Ponce’s group says the risk of death is lower than for operations to remove a gall bladder or replace a hip. However, patients may suffer infection, blood clots, and broken or leaking stitches or staples.

After surgery, side effects can include vitamin deficiencies as food is digested differently, and vomiting as people learn to eat less and chew well.